Dialogue Volume 13 Issue 1 2017 | Page 61

discipline summaries
College ;
• that he practise only under the supervision of the preceptor ;
• that he undergo a comprehensive practice assessment at the end of his preceptorship ; and
• that he abide by all recommendations of his preceptor and the assessor .
Accordingly , Dr . Kamermans underwent a period of preceptorship and supervision with a view to addressing his practice deficiencies .
2015 Practice Assessment – Family Practice The allegations and findings in this hearing related only to Dr . Kamermans ’ ER practice . In determining an appropriate penalty , however , the Committee considered whether the deficiencies the Committee had identified in Dr . Kamermans ’ ER practice could reasonably impact his family practice . The Committee also explored Dr . Kamermans ’ insight into and response to the Committee ’ s prior findings regarding his family practice , as it was the Committee ’ s view that this would help the Committee judge his amenability to rehabilitation . As indicated above , Dr . Kamermans ’ submission was that he should be able to continue family medicine , whereas the College ’ s position was that his certificate of registration should be revoked . The Committee therefore considered evidence arising out of the family practice Discipline Committee Order . This included evidence about the comprehensive assessment of Dr . Kamermans ’ family practice conducted in January , 2015 . The College expert who undertook that assessment opined that Dr . Kamermans failed to maintain the standard of practice of the profession in his practice of family medicine based on her review of 25 of his patient charts , her observation of several patient interactions , and his answers to clinical scenario discussions . The expert had concerns with Dr . Kamermans ’ documentation and clinical management of patients whose charts she reviewed , In addition her written report summarized the following concerns regarding Dr . Kamermans ’ responses to the clinical scenarios :
• Dr . Kamermans lacked awareness of current immunizations and the recommended immunization schedule for pediatric and adult patients ;
• Dr . Kamermans was unable to offer immunizations at his clinic ;
• Dr . Kamermans lacked equipment and supplies to manage a medical emergency given paramedic support and the ER facility are 20 to 30 minutes away ;
• Dr . Kamermans lacked awareness of the Canadian Screening Guidelines impacting his ability to practise preventative health care ;
• Dr . Kamermans was unable to obtain a complete history of the patient ’ s presenting complaints in patients presenting with sore throat , history of a cough , or fatigue ;
• Dr . Kamermans was unable to describe the relevant history , clinical examination , and information regarding developmental milestones in infants and children ;
• Dr . Kamermans responses were not in keeping with the standard of practice for a patient presenting with a history of osteoporosis ; and
• Dr . Kamermans responses were not in keeping with the standard of practice in a post-menopausal patient .
In summary , the expert stated that she had concerns about Dr . Kamermans ’ chart organization , incomplete histories , physical exams , and incomplete management plans . Dr . Kamermans used a list of patient diagnoses as an assessment , instead of an actual statement of the reason why the patient was there for a visit . She also testified that the ER cases that were in issue were similar to what would be seen in family practice , with the exception of the acute cardiac patient . She stated that it is common to see older patients in family practice who have had falls , although it would not be common to see older patients who arrive via ambulance in family practice . The expert testified that she would expect a family physician to be able to assess and manage all of these ER patients ’ clinical presentations in a family practice , including referring them to the ER if needed . The Committee also considered letters of support for Dr . Kamermans , as well as the evidence of two
Full decisions are available online at www . cpso . on . ca . Select Doctor Search and enter the doctor ’ s name .
Issue 1 , 2017 Dialogue 61